Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis.
Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis.
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DOI：
10.1016/j.eclinm.2021.100899
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发表时间：
2021-06
影响因子：
15.1
通讯作者：
Darzi A
中科院分区：
文献类型：
--
作者：
Iqbal FM;Lam K;Sounderajah V;Clarke JM;Ashrafian H;Darzi A
很大一部分人在急性COVID-19感染后会出现挥之不去的虚弱症状。国家卫生与保健卓越研究所（NICE）将持续的症状集群称为COVID后综合征。这已被进一步细分为急性COVID后综合征（症状持续超过初始感染三周）和慢性COVID后综合征（症状持续超过十二周）。该综述的目的是详细描述临床特征的患病率，并确定急性和慢性COVID后综合征的潜在预测因素。进行了无语言限制的系统性文献检索，以识别详细描述COVID后综合征生存率相关特征和结局的研究。最后一次检索于2021年3月6日进行，纳入了所有之前发表的文章。进行了比例荟萃分析，以量化急性和慢性COVID后综合征的特征。使用特定偏倚风险工具评估研究质量。PROSPERO注册：CRD 42020222855共有43项研究符合合格标准;其中38项允许进行荟萃分析。疲劳和呼吸困难分别是急性COVID后最常见的症状（0.37和0.35），疲劳和睡眠障碍分别是慢性COVID后综合征（0.48和0.44）。现有证据通常质量较差，存在相当大的偏倚风险，并且是观察性设计。总之，本综述强调了数据采集和解释中的缺陷，在我们的荟萃分析中指出的不确定性，影响了现有知识的适用性。政策制定者和研究人员必须通过适当的资助计划和全球合作研究，重点了解这种情况对个人和社会的影响。
A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome. A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855 A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design. In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.
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